Abuse and Mental Illness: Is There a Connection?

A common assumption we hear at The Hotline is that abuse is caused by a partner’s mental health condition, for example: bipolar disorder, depression, anxiety, post-traumatic stress disorder (PTSD), narcissistic personality, borderline personality or antisocial personality. While these are serious mental health conditions, they do not cause abuse. Nothing in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5) states that a mental illness solely causes a partner to be abusive in a relationship; however, there are a select few diagnoses that can increase the risk of abusive patterns to show up in a relationship and in other areas of life. Mental illness tends to impact all areas of a person’s life, such as work, interactions with friends, family engagement and personal relationships. In contrast, abuse primarily impacts personal relationships and typically not the other areas of life.

Since abusive behaviors happen primarily in one’s intimate partner relationship, it’s common that an abusive partner will not show their negative or harmful behaviors with friends, co-workers or family members. An abusive partner tends to put on what can be considered a “fake mask” for the rest of the world to see. When it’s just the victim and the abusive partner together, that mask comes off and the victim sees a different side that others aren’t allowed to see. The impact of being the only person to see this behavior is often isolating for the victim, as they may think (or the abusive person may even say) that no one else will believe them since no one else has witnessed the abusive behaviors. This also makes it easier for the abusive person to make their partner feel responsible for their abusive behavior, which reinforces the isolation.

Lundy Bancroft, author of Why Does He Do That? (2002), clarifies that an abusive partner’s “value system is unhealthy, not their psychology” (p. 38). Yes, it can appear like an abusive partner has a mental illness when they get upset and use physical or verbal abuse. If the abuse were caused by mental illness, the partner would also yell at and/or hit their family members, friends and coworkers when upset. With domestic abuse, however, the abuser usually yells at and/or hits only their partner.

Abuse and mental illness can coincide. There are cases of individuals who have mental illness and are also abusive to their partners. There are also many individuals who have a mental illness and are healthy and supportive partners. If your partner does have a mental illness and is abusive towards you, it’s important to keep in mind that the mental illness and abusive behaviors need to be addressed separately by the abusive partner. It is the abusive partner’s responsibility to seek out support and create their own plan for managing their mental illness and be accountable for their abusive behavior.

The following questions may help clarify whether what your partner is doing is abuse or abuse with mental illness:

• Does my partner yell or scream at others (friends, coworkers, family members) outside of our relationship?
• Does my partner make others check in to see where they’re at and who they’re with?
• Does my partner hit others outside of our relationship?
• Does my partner minimize or verbally tear down others?
• Does my partner pressure others to do things that they aren’t okay with?
• Does my partner make threats to others when they say something my partner doesn’t agree with?

If you answered no to most of the questions, then most likely your partner is abusive without mental illness. If you answered yes to most of the questions, then it’s possible your partner is abusive and also may be experiencing some form of mental health issue or illness. Lundy Bancroft’s book, Should I Stay or Should I Go?, has a chapter on untangling a partner’s mental health issues from abusive behaviors. Additionally, connecting with a support network, including a domestic violence advocate or counselor who specializes in domestic violence may help support you in determining your options.

Abuse is a choice someone makes in order to maintain power and control over a partner. If a partner is abusive towards you, regardless of whether they have a mental illness or not, they have no right to treat you in that manner. You always deserve to have a healthy, loving, supportive, trusting and safe relationship 100% of the time.